Our Research

Our research addresses head-on the central challenge of asthma applied health research — preventing asthma attacks and asthma deaths. It focuses on developing, testing and implementing interventions which have the potential to achieve substantial, sustained reductions in asthma morbidity and mortality.

Preventing and Managing asthma attacks

We have two key themes. The first focuses on preventing asthma attacks. The second acknowledges the reality that some asthma attacks will continue to occur and works to optimise management to reduce hospitalisation, readmission and deaths.

Within these two themes we consider the following topics to be key to success:

1. supported self-management
2. personalised treatments
3. diagnosis and clinical management
4. identifying those at risk of attacks
5. controlling risk factors
6. improved adherence.

Research topics and projects

Read on for more information about each of the above topics and some highlighted research projects. We will bring work from across these topics together to achieve our vision.

1. Supported self-management

Supported self-management helps people adjust their treatment in response to changes in symptoms. This includes agreeing a Personal Asthma Action Plan. Studies show that this improves day-to-day control and reduces the risk of asthma attacks and time off work/school. However, for many reasons, supported self-management is not widely implemented in practice: less than a quarter of people replying to an Asthma UK web-survey owned an action plan. In a previous project, called PRISMS, we conducted a systematic review of self-management and support interventions that have been tried in the past. Our report suggested that effective interventions used a whole systems approach – targeting patient resources and education, professional training and organisational strategies.

We aim to help general practice teams embed supported self-management into routine asthma care, and in turn help people with asthma to manage their symptoms.

For example, we will:

• Develop resources for people with asthma

• Develop training and support for professionals, and organisational strategies to support self-management

• Test the implementation of asthma self-management

2. Personalised treatments

Asthma has different sub-types and different triggers so not all treatments are suitable for every type of asthma. This topic is looking at how and why different people respond differently to treatment.

We aim to help people with asthma manage their symptoms and maximise the benefits they get from treatment.

For example, we will:

• Develop approaches to target and optimise pharmacotherapies to different asthma phenotypes, and embed these personalised treatments into routine practice

3. Diagnosis and clinical management

Organisation and delivery of NHS care is crucial to help prevent asthma attacks and also in optimising management of asthma to reduce hospitalisations, readmissions and deaths. Diagnosis of asthma can be complicated to get right, and clinical guidelines are not always consistent.

We aim to help clinicians and service delivery teams to give the best possible care for people with asthma.

For example, we will:

• Derive and validate a clinical prediction rule to support the primary care diagnosis of asthma

• Develop enhanced discharge management for people following A&E attendance or hospital admission for asthma

4. Identifying those at risk of attacks

Despite the availability of effective treatments, people with asthma suffer unnecessary symptoms including exacerbations and hospitalisations. Up to 75% of emergency hospital admissions are preventable with better management and support. Being hospitalised because of asthma can be a devastating experience for patients and their families so it is important people understand their asthma and that their exacerbation risk is reduced through support from healthcare professionals.

Effective prevention of asthma attacks requires a switch away from the traditional routine review of control to stratifying and targeting interventions for those at most risk of attack.

We aim to use digitally/data-enabled approaches to identify those most at risk of an attack, empowering healthcare professionals to intervene accordingly.

For example, we will:

• Develop a validated exacerbation risk score

• Evaluate at-risk registers in primary care

• Evaluate interventions to reduce exacerbations

5. Controlling risk factors

Known factors which increase the risk of asthma attacks, including environmental factors and co-morbidities, are often within our control - either individually or as a society.

We aim to identify, evaluate and put in place measures to help to control identified risk factors. 

For example, we will:

• Evaluate the impact of air pollution on children's lung growth, respiratory health and asthma outcomes

6. Improved adherence

Poor asthma adherence to prescribed treatment remains a major challenge in the prevention of asthma attacks and hospitalisations. Advances in inhaler technology and digital support offer the potential to raise adherence to effective levels (80%) for sustained periods.

We aim to help people with asthma manage their symptoms and maximise the benefits they get from treatment.

For example, we will:

• Develop novel, effective scalable interventions to sustainably and cost-effectively improve adherence